MRI safety in practice: The EU directive on work in electromagnetic fields – practical and clinical aspects

The current paper addresses the practical consequences of the EU directive 2004/40/EC passed in 2004 concerning protection of workers from electromagnetic fields (EMF). These consequences were evaluated in detail only after the directive was passed, and they were found to be severe. Consequently, the directive has not yet been implemented fully in the EU member state's legislation, and a revision is expected before this happens in October 2013, the latest. The revised directive is expected to be based on revised recommendations of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), and may in other ways limit the detrimental consequences for MRI, but this is uncertain. Hence the presented summary of consequences is based mainly on the current directive, representing a realistic worst-case scenario, except for a static field limit that will likely be introduced in a revised directive. An estimated 5-8% of current examinations will be severely affected. The inadvertent effects include reduced access to interventional MRI, and to procedures involving personnel in the scanner rooms during scanning, e.g paediatric examinations, and scanning conducted under anaesthesia. Other consequences are increased use of alternative imaging modalities including X-ray based techniques, hindered development of improved MRI techniques, and general consequences of increased complexity and cost